The research proposed has had as its immediate object a survey of the quality of life of 600 kidney transplant patients in the University of California, San Francisco transplant pool. Its crucial aim is to test the hypothesis that personal sovereignty is the nuclear factor of the human quality of life. Its ultimate aim is to lay the groundwork for a useful definition of the quality of human life and to devise some means to measure it. Sovereignty is defined as a person's freedom to exercise his option under the stresses of his life. Factors supporting this sovereignty are resources (finances, time, skills, information, character traits, attributes, solidarity). Constraints are those restrictions which hinder the execution of his options and make for relative degrees of helplessness (complications from surgery or drugs, irresponsibility or lack of concern of health delivery systems, life stress events). These factors are seen in terms of his perspective (his aspirations, ideals, self images, status, etc.) The manner in which a patient allocates his resources at a given point in time (his life trajectory) is his commitment structure. The quality of life is seen as the interaction between his constraints and his resources. There are four major phases in the research, each with its own research technology: (1) Benchmark survey using formal questionnaire, abstracting of patients' records, computer analysis. (2) Repeated measure of the patients' quality of life (time factor) using 100 volunteer patients interviewed in depth every three months. (3) Computer simulated (patient) model. (4) Field research in the health delivery systems by participant-observation. The significance will be a quantitative statement of the quality of life of 600 patients experiencing chronic and catastrophic illness forms and will be of value to all interested in health delivery systems. This research will be of especial importance to clinical medicine (selection of patients, organization of delivery systems), sociology, and society at large (Society has literally not committed itself to the position of the chronic and catastrophically ill person in its midst).